Student University at Buffalo Buffalo, New York, United States
Introduction: Spine fusions are one of the most common procedures in elderly patients. Among this group, these patients typically also balance a multitude of other medical conditions that can require a delicate management of medications. The objective of this study was to identify the impact of an increased number of medications, polypharmacy, and its impact to various postoperative outcomes.
Methods: A retrospective review of patient charts was completed. Data collection included the number of pharmaceutical drugs a patient was actively taken, as self-reported by the patients. Polypharmacy was defined according to previous literature as the patient taking five or more drugs at a single time. Other data collection included patient demographics, preoperative comorbidities, intraoperative outcomes, and postoperative outcomes. Uni-variate analysis was utilized to identify potential differences between groups.
Results: A total of 713 patients were identified. Among these patients 539 (75.6%) of patients utilized five or more drugs at a single time. Preoperatively, the polypharmacy group had significantly higher history of illicit drug abuse (p=0.003), increased American Association of Anesthesiologist (ASA) scores (p < 0.001), increased Charlson Comorbidity index scores (p < 0.001) and were significantly older (p=0.01). In the operating room polypharmacy patients required a larger number of fusion levels (p=0.01), had greater estimated blood loss (p < 0.001), and increased length of stay (p=0.01). The polypharmacy group also had significantly greater estimated blood loss (p < 0.001) and longer hospital stay (p=0.01).
Conclusion : Polypharmacy is an extremely common before and after spine fusions, which leads to an increased rate of adverse perioperative outcomes.
